Marked Sinus Bradycardia in a COVID-19 Patient

The presence of cardiac manifestations, including bradycardia, has been described as a manifestation of coronavirus disease 2019 (COVID-19). Our case report describes a case of sinus bradycardia secondary to possible sinus node dysfunction in an otherwise asymptomatic patient with COVID-19.

We report the case of an unvaccinated 33-year-old female hospitalized due to bradycardia after 4 days of testing positive for COVID-19. She presented with a 1-day history of transitory lightheadedness and dizziness with no other associated symptoms. Sinus bradycardia was recorded on admission, heart rate 52/min that later dropped to 35/min on the second day of admission. Secondary causes of bradycardia were excluded based on the absence of relevant evidence from laboratory work-up and echocardiographic examination.

We recommend baseline ECG monitoring in hospitalized COVID-19 patients, regardless of disease severity, to assess for potential cardiac manifestations.

Cardiac rhythm monitoring is an essential component of staying vigilant against potential complications. It raises the question of how physicians should respond to a patient with marked bradycardia and when should they intervene?